For more than 20 years, richer countries have donated funds to the governments of developing nations in the Pacific Islands region to help them prepare for the multi-sectoral challenges associated with future climate change. It was expected that these funds would be used to raise awareness about the nature of these challenges and to develop and mainstream appropriate adaptation solutions but neither of these goals has been achieved. It appears that the current preparedness of Pacific Island countries for future climate change is little or no better than it was two decades ago (Nunn 2009). It is incumbent upon all concerned, especially aid donors, to understand the reasons for the failure of these initiatives if only to ensure that future assistance is targeted more appropriately and helps embed sustainable solutions to future challenges.